Impact of Virtual Reality on Healthcare Provider Empathy for Older Adults With Sensory Impairment

Abstract Virtual reality (VR) is an innovative technology that can simulate dual sensory impairment so that healthcare providers and others can experience this affliction common in older adults. This study investigated whether VR simulation could increase empathy among healthcare workers. Healthcare providers experienced a 7-minute scenario from the viewpoint of “Alfred”, a 74-year-old with macular degeneration and high frequency hearing loss on a commercial VR headset (Oculus Rift). Using a one-group pre/post-test study design, we measured knowledge, changes in empathy, and assessed participants’ self-reported behavior change. Results showed that participants increased their knowledge and that 9 of 14 empathy items had statistically significant increases. Additionally, 97% of participants agreed or strongly agreed that they would utilize the information learned in their work with patients. In conclusion, evidence suggests VR is an effective intervention to increase empathy and positively change behavior to support persons with sensory impairment.


THE EFFECTS OF A VR TEACHING TOOL ON UNDERSTANDING, COMFORTABILITY, COMPASSION, AND EMPATHY OF STUDENTS AND CAREGIVERS Carrie Elzie, Eastern Virginia Medical School, Norfolk, Virginia, United States
Empathetic care giving is associated with improved patient satisfaction, compliance and outcomes; clinical competence, career satisfaction, and burnout reduction; as well as diminished medical errors and litigation claims. Unfortunately, recent studies have shown erosion in empathy and compassion across the health professions. Virtual reality shows promise as a teaching tool to combat this decline as it has been dubbed the ultimate empathy machine, allowing users to vividly and viscerally experience any situation from any perspective. Embodied Labs allows users to virtually walk in the shoes of different patients, experiencing symptoms, family dynamics, support networks and various components of the health care systems. We have demonstrated that the high level of immersion and presence afforded by these virtual labs are effective pedagogical tools to increase understanding, comfortability, compassion and empathy within various populations including informal caregivers, high school students, health professional students and medical students.

VIRTUALLY TRANSFORMATIVE EXPERIENCES IN GERIATRIC EDUCATION: LESSONS PRE AND POST PANDEMIC Pamela Saunders, Georgetown University, WASHINGTON, District of Columbia, United States
Georgetown University medical students have the option of selecting a two-week rotation in Geriatrics during their third-year. Since Fall 2019, the curriculum has included three immersive virtual reality (VR) labs: hearing & vision loss, Alzheimer's disease, and end-of-life conversations created by Embodied Labs. The curricular goals include increasing empathy and sensitivity of learners to the perspective of older adults, decreasing ageism & stereotyping, and increasing clinical knowledge. In each lab, students are immersed in a live film, first-person point of view of an older adult. They interact with the immersive environment via gaze, voice, and natural hand motions. Pre-pandemic, students viewed the labs in-person using a commercial VR headset. Since the pandemic, March 2020, students accessed the VR labs through the virtual modality of Zoom. This abstract summarizes data on knowledge and attitudes examining differences in knowledge and attitudes pre and post-pandemic.

IMPACT OF VIRTUAL REALITY ON HEALTHCARE PROVIDER EMPATHY FOR OLDER ADULTS WITH SENSORY IMPAIRMENT Suzanne Dutton, Sibley Memorial Hospital/Johns Hopkins, washington, District of Columbia, United States
Virtual reality (VR) is an innovative technology that can simulate dual sensory impairment so that healthcare providers and others can experience this affliction common in older adults. This study investigated whether VR simulation could increase empathy among healthcare workers. Healthcare providers experienced a 7-minute scenario from the viewpoint of "Alfred", a 74-year-old with macular degeneration and high frequency hearing loss on a commercial VR headset (Oculus Rift). Using a one-group pre/post-test study design, we measured knowledge, changes in empathy, and assessed participants' self-reported behavior change. Results showed that participants increased their knowledge and that 9 of 14 empathy items had statistically significant increases. Additionally, 97% of participants agreed or strongly agreed that they would utilize the information learned in their work with patients. In conclusion, evidence suggests VR is an effective intervention to increase empathy and positively change behavior to support persons with sensory impairment.

REMOTE DELIVERY OF VIRTUAL REALITY PATIENT SIMULATIONS FOR NURSING EDUCATION Jaime Hannans, California State University Channel Islands, Simi Valley, California, United States
In the midst of rapid transfers to online teaching for experiential learning opportunities in nursing clinical labs this past spring due to the pandemic, nursing simulations with immersive virtual reality (VR) in VR headsets were deemed impossible. In partnership with Embodied Labs, nursing faculty pivoted to facilitating VR using remote learning approaches in groups. In this new VR approach nursing students engaged in active learning, critical discourse, and reflection guided by faculty delivered VR scenarios remotely with in-session debriefing during discussion pause points. Complex scenarios focused on patient or family perspectives (e.g. during end-of-life care or navigating community and healthcare needs as a LGBTQ individual). These were valuable online learning opportunities for undergraduate nursing education. Student feedback was positive, and faculty perceptions indicated using VR remote learning offers rich, engaging discussion through complex topics important to nursing clinical practice.

AN EVALUATION OF THE SERVICE INTENSITY ADD-ON PAYMENT POLICY REFORM IN THE MEDICARE HOSPICE BENEFIT
Thomas Christian, 1 Pedro Gozalo, 2 Joan Teno, 3 and Michael Plotzke, 4 , 1. Abt Associates,Cambridge,Massachusetts,United States,2. Brown University,Providence,Rhode Island,United States,3. Oregon Health and Science University,Portland,Oregon,United States,4. Abt Associates,Saint Louis,Missouri,United States In 2016, the Centers for Medicare & Medicaid Services (CMS) implemented the Service Intensity Add-On (SIA) payment, which incentivized skilled nurse and medical social worker (SN/MSW) visits in the last seven days of life. Little is known about the impact of this initiative. Using 100% Medicare hospice claims, we identified a 10% random sample of Medicare hospice beneficiaries utilizing routine home care service during calendar years 2012-2018. We compared the provision of SN/MSW visits on service dates before and after the SIA's implementation relative to beneficiaries' date of death. We also determined hospice providers' success in providing SN/MSW visits in the last days of life and categorized all providers into quintiles according to the average rate of these visits in the period prior to the SIA's implementation. Cumulative over the last seven days of life, we calculated an increase of 15.7 SN/MSW minutes (95% confidence internal [CI] 14.9-16.5 minutes) per beneficiary after the SIA was implemented. The per-minute increase was greatest on days nearer to death (4.0 minutes day of death, 95% CI 3.6-4.2). There was no detectable visit increase on days which were ineligible for the SIA. Additionally, those providers in the quintile providing the lowest rate of SN/ MSW visits pre-SIA exhibited a 14-percentage point increase in rates of these visits, the third, fourth, and fifth quintiles exhibited little change over time. Further monitoring is needed to ensure beneficiaries receive adequate end-of-life care.